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KIDKARE MEDICAL PA
NPI 1386856029
Clinic/Center in Fair Lawn, NJ

Active since May 04, 2007CLIA 31D2166444 · Waiver
15-01 BROADWAY STE 36, FAIR LAWN, NJ 07410(201) 773-6171(201) 773-4845 Get Directions Write a Review

NPPES record last updated: June 23, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kidkare Medical Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIDKARE MEDICAL PA (NPI 1386856029) is a healthcare organization registered as a clinic/center in Fair Lawn, New Jersey and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through May 16, 2027 and lists Irina Bass, Pediatrician, as its authorized official.

NPPES Registry Identity

NPI1386856029
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameKIDKARE MEDICAL PA
Location Address15-01 BROADWAY STE 36Fair Lawn, NJ 07410-6006
Mailing Address15-01 Broadway Ste 36Fair Lawn, NJ 07410-6006 · (201) 773-6171 · Fax (201) 773-4845
Phone(201) 773-6171
Fax(201) 773-4845
Organization SubpartNo
Authorized OfficialIrina BassPediatrician · (201) 773-6171
Enumeration DateMay 4, 2007
Last NPPES UpdateJune 23, 2016
✔ NPI 1386856029 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in NJ · 25MA07639000
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
15-01 BROADWAY STE 36, Fair Lawn, NJ 07410
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Other Identifiers 4

Medicare ID-Type Unspecified098077NJ
Medicaid0081787NJ
Other1346212156NJ · Individual Npi
Medicare UPIN149124NJ

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D2166444

Kidkare Medical Irina Bass · Fair Lawn, NJ
Active · expires May 16, 2027
CLIA Number31D2166444
Laboratory TypePhysician Office
Certificate Effective DateMay 17, 2025
Certificate Expiration DateMay 16, 2027
Laboratory DirectorIrina Bass
Laboratory Phone(201) 773-6171
Laboratory LocationKidkare Medical Irina Bass15-01 Broadway Ave, Suite 36, Fair Lawn, NJ 07410
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kidkare Medical PA's NPI number?

The NPI number for Kidkare Medical PA is 1386856029. It was assigned to this organization in the NPPES registry on May 4, 2007.

Where is Kidkare Medical PA located?

Kidkare Medical PA is located at 15-01 Broadway Ste 36, Fair Lawn, NJ 07410. The listed phone number is (201) 773-6171.

What is Kidkare Medical PA's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Kidkare Medical PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2166444) is associated with this NPI, valid through May 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kidkare Medical PA was last updated on June 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.